Fitting children into child restraints

Rear-facing restraints

Babies

Children under 12 months old are best protected in either an infant restraint or a rear-facing convertible restraint. This is because a baby’s skeleton and muscles can’t adequately support the head and spinal cord until they are 12 months old. The baby’s back is its strongest surface. When the restraint is rear-facing, crash forces are spread through the baby’s back and offer the best protection (frontal crashes are the most common). Facing the rear also keeps the head in line with the upper body. The baby’s head and body are pushed back into the restraint when it faces the rear but they are thrown forward when the restraint faces forward.

Infant restraints

An infant restraint can be used for babies weighing up to 9 kg or up to 13.5 kg, depending on the make and model. Check this in the manufacturer’s fitting instructions. It will have a handle for carrying and a three or five-point harness. Most infant restraints are held in place with either the lap or the lap/sash safety belt. How the safety belt is threaded through the restraint will vary depending on the make and model so always check the fitting instructions.

Some infant restraints are designed to attach to a stroller but the safety belt shouldn’t be threaded through the stroller attachment point when installing the restraint in a vehicle.

Convertible restraints

These convert from a rear-facing to a forward-facing position. A convertible restraint will have a five or six-point harness. They have a weight range for rear-facing of up to 9 kg or up to 13.5 kg. A 13.5 kg rear-facing model offers babies between birth and 12 months of age the best protection in a crash.

Putting a baby in a restraint

The baby should be placed with their bottom well back in the restraint. Positioning the baby snuggly helps the harness fit correctly and holds the baby securely in the restraint. The harness keeps the baby low and contained within the restraint. It’s the frame of the restraint itself that distributes the force of the crash.

The harness is placed over the baby’s shoulders level with, or slightly below the top of the shoulders. In a frontal crash, having the harness level with or slightly below the shoulders helps prevent the baby sliding up the restraint which may cause neck injuries.

The harness should be firm against the baby with no more than a finger’s width of slack between the baby and the harness. Always give the harness a tug to make sure that the harness adjustor is holding fast. In some instances, the harness may not actually touch the baby. This can occur when a very small baby is placed in a convertible restraint with a five or six-point harness or a T-shield. Another restraint should be tried if there is a gap here. If there is a gap between the baby’s crotch and the crotch strap, a rolled small towel or cloth nappy can be placed in the gap. The harness should be as close as possible to the baby. Blankets or wraps are always put over the baby after the harness is in place. A blanket or thick padding under the baby will be compressed in a crash, allowing the harness to slacken.

Some restraints have a chest-harness tie (also known as a harness retainer clip). The chest tie is placed across the chest at the level of the baby’s armpits – not up towards the neck. It holds the shoulder harness in the correct position. If a child is always wriggling out of a restraint without a chest tie, try a restraint with a chest tie or put a chest tie on the existing restraint (not ideal but better than an unsecure child and distracted driver).

For a small baby with poor head support, use rolled small towels or a head snuggler to support the head and align it with the rest of the body.

Outgrowing the restraint

A baby has outgrown the infant restraint when their head is over the top of the restraint when they are at the maximum recommended weight. Feet hanging over the end of the restraint aren’t a problem. If the baby is under 12 months old, move them to a rear-facing restraint with a higher maximum weight restriction. Not all convertible restraints can be used in the rear-facing position for a baby under 12 months old – the recommended weight range will show whether or not this is possible. Always check the fitting instructions.

Advice for parents of small or premature babies

• Seek medical advice on the best way to transport these babies
  Current information suggests that babies born at less than 37 weeks should be observed in a restraint before being discharged from hospital. This is to monitor for any periods of not breathing, the heart rate slowing or decreased oxygen levels.
• Limit the amount of travel as much as possible
  When travelling, take care that the baby’s head doesn’t fall forward and obstruct the airway. Placing the baby correctly in the restraint will help the baby maintain the best position. Families should minimise travel for babies with respiratory difficulties as the position of the restraint could compromise breathing for some babies.
• Have an adult sitting beside them in the back of the vehicle
  A very small or premature baby may need to travel lying flat. A conventional child restraint that allows for proper positioning should be chosen if the baby can maintain a semi-upright position safely. Having an adult next to the baby allows for better observation.

Placing the premature baby in a restraint

• If the restraint offers two crotch strap positions, use the strap closest to the back of the restraint to help prevent baby slumping forward.
• If the restraint has low harness slots, use these to help prevent the harness from coming up over the baby’s ears.
• Baby’s back and bottom should be against the restraint.
• Rolled blankets placed either side of the body will provide side support for the head and neck.
• A small rolled blanket put between the crotch strap and the baby will reduce slouching.
• Recline the restraint halfway back on the vehicle seat at about a 45-degree angle. You may need to use a firm rolled small towel under the foot end of the restraint to achieve this.
  (adapted from the American Academy of Paediatrics Policy Guidelines)

Advice for parents of children with special needs

It’s often a case of trial and error when searching for the best restraint for a child with special needs. Several restraints assist children who need extra support with their stability when travelling. Manufacturers and importers can be contacted for advice and assistance to get the safest fit for the child.

It can be difficult to find a restraint that accommodates the splayed legs of a baby in a hip plaster. Some manufacturers can supply an additional polystyrene insert that sits under the buttocks and provide a longer crotch strap.

Forward-facing restraints

Some restraints are forward-facing only. Their normal weight range is 9 to 18 kg.

Putting a child in a restraint

A child should sit with their bottom well back into the seat. The harness is placed over their shoulders level with or slightly above the top of the shoulders. The harness is firm against the child with no more than a finger’s width of slack. If there is a chest-harness tie, place it across the chest at the level of the child’s armpits – not up toward the neck. If placed too close to the neck, it could strangle the child if the child slides up and down during a crash. A chest-harness tie holds the shoulder harness in the correct position.

Always check the fitting instructions for the correct shoulder strap position. With some convertible restraints, you can use the top slots only when the restraint is in a forward-facing position. This is because only the top slots are reinforced enough to take the extra load of the heavier child in a crash.

Booster seats

A booster seat is an approved child restraint. Use a booster seat once a child has outgrown the forward-facing restraint and until the child can fit a safety belt while sitting on the vehicle seat. Until then, the child restraint offers more protection in a crash. A booster seat lifts the child up so that the vehicle lap/sash safety belt will fit across the shoulder and not the neck. Most children under seven still need a booster seat to get the safety belt to fit correctly. A booster seat should never be used with just a lap belt as the child will be folded in half and hit their head on their knees or the seat in front of them in a crash.

Weight recommendations for booster seats vary depending on what standard they meet. Some restraints convert to a booster seat when the child has outgrown the restraint’s harness. A half-booster seat (one without a back) is fine to use as long as the child’s head is not above the vehicle seat back. If it is, a booster with a back will offer better protection.

There is a tendency for parents to want to move a child into a booster seat before they have outgrown the child restraint. The child restraint offers better protection in a crash because of its frame and its harness system. If you can explain this, you may be able to delay the move to a booster seat.

Child harness

A child harness is an approved child restraint. It prevents the child doubling over in a crash or sudden stop. The harness is used with the vehicle lap or lap/sash belt.
It can be used for children 14 to 32 kg (around three to eight years old) whose shoulders don’t come over the top of the vehicle seat back or headrest. The harness can also be used with a booster seat for children weighing 14 to 26 kg whose eye level is below the top of the vehicle seat or headrest.
Make sure the lap belt sits low down on the child’s pelvis or thighs.

Safety belt adjustors

Several devices on the market are designed to adjust the safety belt to sit correctly against the child. If the adjustor is not positioning the safety belt correctly, it shouldn’t be used. Safety belt adjustors should comply with an accepted standard and be used according to the fitting instructions.

Last updated: 11 May 2005